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Cancer - Throat or Larynx

Definition

Cancer of the throat is cancer of the vocal cords, voice box (larynx), or other areas of the throat.

Alternative Names

Vocal cord cancer; Throat cancer; Laryngeal cancer; Cancer of the glottis

Causes

People who smoke or use tobacco are at risk of developing throat cancer. Excessive alcohol use also increases risk. Smoking and drinking alcohol combined lead to an increased risk for throat cancers.

Most cancers of the throat develop in adults older than 50. Men are 10 times more likely than women to develop throat cancers.

Symptoms

  • Abnormal (high-pitched) breathing sounds
  • Cough
  • Coughing up blood
  • Difficulty swallowing
  • Hoarseness that does not get better in 1 - 2 weeks
  • Neck pain
  • Sore throat that does not get better in 1 - 2 weeks, even with antibiotics
  • Swelling or lumps in the neck
  • Unintentional weight loss

Exams and Tests

The doctor will perform a physical exam. This may show a lump on the outside of the neck.

Tests may include:

  • Biopsy of suspected tumor
  • Chest x-ray
  • CT scan of chest
  • CT scan of head and neck

Treatment

The goal of treatment is to completely remove the cancer and prevent it from spreading to other parts of the body.

When the tumor is small, either surgery or radiation therapy alone can be used to remove the tumor.

When the tumor is larger or has spread to lymph nodes in the neck, a combination of radiation and chemotherapy is often used to preserve the voice box.

Some patients need surgery to remove the tumor, including all or part of the vocal cords (laryngectomy). If you have a laryngectomy, speech therapy can help you learn other ways to talk.

Many patients also need swallowing therapy after treatment to help them adjust to the changes in the structure of the throat.

Support Groups

You can ease the stress of illness by joining a support group of people who share common experiences and problems.

Outlook (Prognosis)

Throat cancers can be cured in 90% of patients if detected early. If the cancer has spread to surrounding tissues or lymph nodes in the neck, 50 - 60% of patients can be cured. If the cancer has spread (metastasized) to parts of the body outside the head and neck, the cancer is not curable and treatment is aimed at prolonging and improving quality of life.

After treatment, patients generally need therapy to help with speech and swallowing. A small percentage of patients (5%) will not be able to swallow and will need to be fed through a feeding tube.

Possible Complications

  • Airway obstruction
  • Difficulty swallowing
  • Disfigurement of the neck or face
  • Hardening of the skin of the neck
  • Loss of voice and speaking ability
  • Spread of the cancer to other body areas (metastasis)

When to Contact a Medical Professional

Call your health care provider if:

  • You have symptoms of throat cancer, especially hoarseness or a change in voice with no obvious cause that lasts longer than 3 weeks
  • You find a lump in your neck that does not go away in 2 - 3 weeks

Prevention

Avoid smoking and other tobacco exposure. Limit or avoid alcohol use.

References

National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Head and Neck Cancers. National Comprehensive Cancer Network; 2010. Version 2.2010.

Posner M. Head and neck cancer. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 200.

Armstrong WB, Vokes DE, Maisel RH. Malignant tumors of the larynx. In: Flint PW, Haughey BH, Lund VJ, et al, eds. Cummings Otolaryngology Head and Neck Surgery. 5th ed. St. Louis, Mo: Mosby Elsevier; 2010:chap 107.